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Clinical Characteristics, Outcomes, and Complications Associated With Delayed Diagnosis of Intraocular Foreign Body
Journal article   Peer reviewed

Clinical Characteristics, Outcomes, and Complications Associated With Delayed Diagnosis of Intraocular Foreign Body

Melissa Yuan, Lindsay K Kozek, Sandra Hoyek, Jose Davila, Leo Kim, Filippos Vingopoulos, Dan Gong, Lucy Young, Frances Wu, Grayson Armstrong, …
Journal of vitreoretinal diseases (Print), Vol.9(4), pp.459-466
07/2025
DOI: 10.1177/24741264251339090
PMCID: PMC12122470
PMID: 40453423

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Abstract

To describe the clinical characteristics, outcomes, and complications in cases of intraocular foreign bodies (IOFBs) when the diagnosis is missed or delayed. This nonconsecutive case series was a retrospective multicenter study of adult patients with a delayed diagnosis of IOFB, defined as initially presenting elsewhere with a missed diagnosis or a delay of more than 24 hours to seek care. Eighteen eyes were included. The mean (±SD) presenting logMAR visual acuity (VA) was 0.45 ± 0.70 (Snellen equivalent, 20/56). The most common presenting symptom was decreased vision (11 patients [61%]). The general emergency department setting accounted for most initial evaluations (11 patients [61%]); however, 6 patients (33%) were seen in an outpatient setting by an optometrist, ophthalmologist, or both. The most common anatomic locations of the IOFBs were in the iris/anterior chamber (4 [22%]) or lens (4 [22%]) followed by the pars plana/ciliary body (3 [17%]), vitreous (3 [17%]), or retina (3 [17%]). Complications at presentation included endophthalmitis (1 [6%]), retinal detachment (1 [6%]), and retinal tears (4 [22%]). Five patients (28%) had siderosis at presentation. The mean final logMAR VA was 0.13 ± 0.32 (Snellen equivalent, 20/26). At the last follow-up, 15 eyes (83%) had a VA of 20/30 or better. The median follow-up was 139 days (IQR, 86-557). Eyes with a delayed diagnosis of IOFBs often present with good vision and self-sealing wounds. Missed IOFBs can be associated with siderosis, RD, and endophthalmitis. Visual outcomes may be salvaged with prompt treatment.
open-globe injury delayed IOFB intraocular foreign body

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